Items starting with T

RESULTS - Positive, Negative, Borderline and Indeterminate results. 

A negative result suggests no active immune response to Mycobacterium Tuberculosis.  A positive results indicates a response to MTB infection, but does not distinguish between active and latent disease. The test cannot be used to exclude active infection, since false-negative results do occur. It should always be interpreted in the context of other clinial and laboratory features.

Due to biological variations, re-testing of borderline (equivocal) results is recommended. Indeterminate results indicate failure of positive or negative controls which may be due to technical or patient-specific factors.  Re-testing recommended.  

Negative

Povided by reference laboratory

Severe Staph.aureus infection including IE = Pre dose >20 but <60 Other severe infections = Pre >10 but <60

Therapeutic targets remain only loosely defined and appear to vary depending on the purpose of therapy. A reference range of 18 - 63 mg/L has been suggested. Adverse reactions to leflunomide do not correlate well with serum drug concentration, but include diarrhoea, hypertension, and liver toxicity. 

Please contact the laboratory for more information.

10-20 mg/L (Therapeutic Range)

For children and young adults with ALL, please refer to your protocol directed guidance. The guidelines below apply to azathioprine/6-mercaptopurine immunosuppression.

TGN therapeutic range 235-450 pmol/8x10E8 RBC

*(TGN <235). TGN below the therapeutic range. Question adherence. Consider dose incrementing if the patient is adherent. If the MeMP/TGN ratio is >11, consider changing therapy to 25% of the target thiopurine dose with 100 mg allopurinol.

*(TGN 235-450). TGN within the therapeutic range. The patient is appropriately dosed. If the patient is not responding to therapy, consider alternative immunosuppressant  therapies. Where MeMP > 5700, there is an increased risk of hepatotoxicity, in such patients consider changing therapy to 25% of the target thiopurine dose with 100mg allopurinol.

*{TGN >450). TGN above the therapeutic range. Dose reduction is advisable if TGN levels are above 550, depending on clinical situation. If patient is not responding to therapy, consider alternative immunosuppressant  therapies.

For 6MMP, therapeutic range is <5700 pmol/8x10E8 RBC

Repeat TGN measurement 4 - 6 weeks after any change in therapy. 

TPMT phenotype/activity reference ranges:

<6 nmol/ghb/hr = Deficient

6-34 nmol/gHb/hr = Low

35-79 nmol/gHb/hr = Normal

>79 nmol/gHb/hr = High

TPMT genotype classifications:

WT = wild-type, normal result

H3 = TPMT 1*/3* - heterozygous for TPMT, this would indicate a reduced activity.  Advise reduce dose of azothioprine.